The proposed CMHAA would build on Dr. Streim's established clinical expertise in geriatric psychiatry with relevance to the treatment and rehabilitation of medically ill elderly patients, and would allow him to proceed to the next logical stage in his career by supporting him in the development of research skills that are necessary to conduct clinical investigations in this area. Research proposed to serve as a vehicle for training and career development includes (1) naturalistic longitudinal studies evaluating the impact of depression and other psychiatric symptoms on access to rehabilitation services, on functional improvement of elderly patients on an inpatient rehabilitation unit, and on maintenance of gains after hospital discharge; (2) a psychopharmacologic intervention study designed to evaluate the impact of treating depression on the functional gains from rehabilitation; and (3) development of models that can be used to characterize the longitudinal course of rehabilitation and recovery in elderly patients and that will thereby enable further research on the psychiatric determinants of outcome.